Planning Target Volume Margin Assessment Using Daily Cone Beam Computed Tomography Image Verification in Prostate Cancer Patients
Introduction: Conformal radiation techniques are widely used in prostate cancer treatment as it improves the therapeutic ratio. However, inter- and intra-fraction variations remain challenging, which reflects on the planning target volume (PTV) margin. This study aimed to determine the benefit of da...
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Mashhad University of Medical Sciences
2025-02-01
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| Series: | Iranian Journal of Medical Physics |
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| Online Access: | https://ijmp.mums.ac.ir/article_23427_e8c2f4275149f34f7e136c54fdfc36ae.pdf |
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| author | Pushpaja Ullattil Lakshmi Susheela Haridas Nair Anoop Remesan Nair Sneha Nair Sreelekshmi G Prasath Bhaskaran Beena Kunheri |
| author_facet | Pushpaja Ullattil Lakshmi Susheela Haridas Nair Anoop Remesan Nair Sneha Nair Sreelekshmi G Prasath Bhaskaran Beena Kunheri |
| author_sort | Pushpaja Ullattil |
| collection | DOAJ |
| description | Introduction: Conformal radiation techniques are widely used in prostate cancer treatment as it improves the therapeutic ratio. However, inter- and intra-fraction variations remain challenging, which reflects on the planning target volume (PTV) margin. This study aimed to determine the benefit of daily Cone Beam Computed Tomography (CBCT) in reducing the PTV margin.
Material and Methods: 51 patients over 3 years were included in the study. PTV was obtained by applying 8mm in left-right (LR) and anterior (A), 5mm in posterior (P) and 8mm in superior-inferior (SI) directions of clinical target volumes (CTV). Pelvic bones of CBCT were matched with the planning CT scan and manually adjusted with soft tissue, assessing the total inter-fraction error. Values were registered in left-right (X), superior-inferior (Y), and anterior-posterior (Z) directions.
Results: The median age was 71 years and 84.3% were in the high-risk group. The mean inter-fraction error (Mp) was obtained in all three principal axes (x, y, z). The majority had shifts ≤ 0.3cm. None recorded a shift >1cm. The Random errors were 0.44cm in LR (X), 0.36cm in SI (Y) and 0.40cm in AP (Z) directions. The systematic errors were 0.05cm in LR (X), 0.04cm in SI (Y) and 0.04cm in AP (Z) directions. The PTV margin was calculated using van Herk’s formula and obtained as 0.68cm.
Conclusion: Routine use of CBCT significantly reduces the random and systematic errors and ensures safer dose escalation with reduced PTV margin. |
| format | Article |
| id | doaj-art-798ec57ce4db4a4fa6761b5121492801 |
| institution | OA Journals |
| issn | 2345-3672 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Mashhad University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Medical Physics |
| spelling | doaj-art-798ec57ce4db4a4fa6761b51214928012025-08-20T02:12:15ZengMashhad University of Medical SciencesIranian Journal of Medical Physics2345-36722025-02-01221505510.22038/ijmp.2023.65971.213523427Planning Target Volume Margin Assessment Using Daily Cone Beam Computed Tomography Image Verification in Prostate Cancer PatientsPushpaja Ullattil0Lakshmi Susheela1Haridas Nair2Anoop Remesan Nair3Sneha Nair4Sreelekshmi G5Prasath Bhaskaran6Beena Kunheri7Department of Radiation Oncology, Amrita Institute of Medical Sciences and Research, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, AIMS, Ponekkara P.O., Kochi, Kerala, Pin Code 682041Department of Radiation Oncology, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, AIMS Ponekkara PO, Kochi, Kerala, Pincode 682041Department of Radiation Oncology, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, AIMS Ponekkara PO, Kochi, Kerala, Pincode 682041Department of Radiation Oncology, Amrita Institute of Medical Sciences and Research, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, AIMS, Ponekkara PO, Kochi, Kerala, Pin code 682041.Department of Medical Physics and Radiation Safety Amrita Institute of Medical Sciences, Amrita University Kochi, Kerala, 682041 IndiaDepartment of Radiation Oncology, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, AIMS Ponekkara PO, Kochi, Kerala, Pincode 682041Department of Radiation Oncology, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, AIMS Ponekkara PO, Kochi, Kerala, Pincode 682041Department of Radiation Oncology Amrita Institute of Medical Sciences, Amrita University Kochi, Kerala, 682041 IndiaIntroduction: Conformal radiation techniques are widely used in prostate cancer treatment as it improves the therapeutic ratio. However, inter- and intra-fraction variations remain challenging, which reflects on the planning target volume (PTV) margin. This study aimed to determine the benefit of daily Cone Beam Computed Tomography (CBCT) in reducing the PTV margin. Material and Methods: 51 patients over 3 years were included in the study. PTV was obtained by applying 8mm in left-right (LR) and anterior (A), 5mm in posterior (P) and 8mm in superior-inferior (SI) directions of clinical target volumes (CTV). Pelvic bones of CBCT were matched with the planning CT scan and manually adjusted with soft tissue, assessing the total inter-fraction error. Values were registered in left-right (X), superior-inferior (Y), and anterior-posterior (Z) directions. Results: The median age was 71 years and 84.3% were in the high-risk group. The mean inter-fraction error (Mp) was obtained in all three principal axes (x, y, z). The majority had shifts ≤ 0.3cm. None recorded a shift >1cm. The Random errors were 0.44cm in LR (X), 0.36cm in SI (Y) and 0.40cm in AP (Z) directions. The systematic errors were 0.05cm in LR (X), 0.04cm in SI (Y) and 0.04cm in AP (Z) directions. The PTV margin was calculated using van Herk’s formula and obtained as 0.68cm. Conclusion: Routine use of CBCT significantly reduces the random and systematic errors and ensures safer dose escalation with reduced PTV margin.https://ijmp.mums.ac.ir/article_23427_e8c2f4275149f34f7e136c54fdfc36ae.pdfprostate intensity modulated radiotherapy conebeam computed tomography |
| spellingShingle | Pushpaja Ullattil Lakshmi Susheela Haridas Nair Anoop Remesan Nair Sneha Nair Sreelekshmi G Prasath Bhaskaran Beena Kunheri Planning Target Volume Margin Assessment Using Daily Cone Beam Computed Tomography Image Verification in Prostate Cancer Patients Iranian Journal of Medical Physics prostate intensity modulated radiotherapy cone beam computed tomography |
| title | Planning Target Volume Margin Assessment Using Daily Cone Beam Computed Tomography Image Verification in Prostate Cancer Patients |
| title_full | Planning Target Volume Margin Assessment Using Daily Cone Beam Computed Tomography Image Verification in Prostate Cancer Patients |
| title_fullStr | Planning Target Volume Margin Assessment Using Daily Cone Beam Computed Tomography Image Verification in Prostate Cancer Patients |
| title_full_unstemmed | Planning Target Volume Margin Assessment Using Daily Cone Beam Computed Tomography Image Verification in Prostate Cancer Patients |
| title_short | Planning Target Volume Margin Assessment Using Daily Cone Beam Computed Tomography Image Verification in Prostate Cancer Patients |
| title_sort | planning target volume margin assessment using daily cone beam computed tomography image verification in prostate cancer patients |
| topic | prostate intensity modulated radiotherapy cone beam computed tomography |
| url | https://ijmp.mums.ac.ir/article_23427_e8c2f4275149f34f7e136c54fdfc36ae.pdf |
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